Welcome!

Baby sleep webinar trouble sleeping restless baby

Many thanks for booking my

FULL SUPPORT baby SLEEP PACKAGE

Let’s Prepare for your first online consultation call.

Please complete the below consultation form at least 24 hours prior to your appointment time. The information on this form is important as will guide my approach and help me better assist you with any sleep challenges.

Consultation Intake Form

*Please complete all questions above as best you can. If you have any worries or concerns regarding any of the questions above, we will go through these our call.

Name of parent/carer

Email address

Contact Number

Name of baby

Details and Information


 

Baby's date of birth

Are there any medical issues I should be aware of?

Please describe the medical condition here

Gestation when born (how many weeks when born)

Age of baby

Is your baby breast/formula/combination fed?

Tell me about your family - how many children, other parent/carer in the home etc?

About Your baby


 

Do you have a feeding routine? If so, please describe (eg they feed on demand or on a schedule etc. Please include night feeds)

How would you describe your child’s temperament?

Your Baby and Sleep


Does your baby use a soother? If so, when? Eg all day/night, just at night or during naps etc

Describe if any, your baby's day routine

What is your biggest sleep challenge with your baby and why?

Describe, if any, your baby’s bed time/night routine

If your baby wakes during a nap/at night - how do you usually respond or try to settle them back to sleep? What has worked/not worked?

Describe your baby’s sleep environment - eg do they sleep in a cot in your bedroom/seperate bedroom, only do contact naps or naps on the go (sling/car/pram)?

Have you had previous sleep training?

About You


Are you stressed about your current sleep situation? If so, please tell me how stressed you are on a scale of 1-10 (1 being not stressed at all, 10 being very stressed).

If I had a magic wand - what is the best sleep outcome you would hope to achieve by the end of our time working together?

Do you have any commitments in the next 2 weeks - eg trips away, visitors, plans etc?

Please explain your availability here.

share diary Are you willing to keep an informal sleep diary throughout this process to share with me? This can be bullet points about naps, how nights are going etc so we can tweak the plan as needed.

Share your review of my service? Are you willing to share a testimonial with me after working together and give me permission to use this on my website/social channels in the future? Eg how you found the plan, how you found working with me and share improvements etc? It would only include your first name and age of baby.

4 + 11 =